schatzker ⅳ型胫骨平台骨折治疗进展

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1、授予单位代码10089学号或申请号20153368中国图书分类号R274.12硕士学位论文专业学位SchatzkerIV型胫骨平台骨折治疗进展研究生：孔宇导师：彭阿钦教授专业：外科学二级学院：第三医院2018年3月目录中文摘要················································································1英文摘要··························································

2、······················2英文缩写················································································4综述SchatzkerIV型胫骨平台骨折治疗进展··································5参考文献···············································································18致谢··

3、···················································································23个人简历···············································································24中文摘要SchatzkerIV型胫骨平台骨折治疗进展摘要Schatzker分类是临床上最常用的胫骨平台骨折分类系统。根据受伤机制及骨折部位将骨折分为六种类型。而Schatz

4、kerIV型骨折是一种特殊类型的胫骨平台骨折，其损伤机制多为屈膝内翻加轴向暴力所致，在所有胫骨平台骨折人数中所占比例为10%-30%，合并软组织损伤的几率较高，通常需选择手术治疗，手术时机的选择与软组织损伤情况密切相关。对骨折复位来说，较早的进行手术相对较容易，但是也相对增加了术后并发症的发生率。理想的手术入路要根据骨折的部位，类型及周围软组织损伤情况综合考虑，只有正确的选择手术入路及内固定植入物的应用，才能增加骨折愈合的几率，同时降低伤口感染、骨折不愈合等相关并发症的发生。骨折类型的详细分析，特别是关节面

5、的移位、粉碎程度，骨折线的位置等对于骨折的复位及内固定物的应用极其重要，因此计算机断层扫描（CT）的应用对理解骨折类型十分必要，通过冠状面与矢状面的重建，能够清晰地显示骨折的形态和主要关节面的位置，从而准确的分析受伤机制，并设计手术切口、复位方式和内固定的方案。磁共振成像（MRI）扫描有助于全面了解膝关节周围软组织及韧带的损伤情况，进而有针对性地合理安排治疗方案。目前，关于SchatzkerIV型胫骨平台骨折的分类和治疗方法还存在很多差异，本文就针对SchatzkerIV型胫骨平台骨折分型、治疗方法以及相关

6、并发症等方面进行综合阐述。关键词：胫骨平台骨折，分型，病理类型，术后并发症，手术入路1英文摘要TreatmentprogressofSchatzkerIVtypetibialplateaufractureABSTRACTTheSchatzkerclassificationisthemostcommonlyusedclinicaltibialplateaufractureclassificationsystem.Accordingtotheinjurymechanismandfracturesite,thef

7、racturesweredividedintosixtypes.TheSchatzkerIVfractureisaspecialtypeoftibialplateaufracture.Theinjurymechanismismostlyduetoflexionandinversionandaxialviolence.Thepercentageofalltibialplateaufracturesis10%to30%,combinedwithsofttissueinjury.Thechanceishigh,u

8、suallyneedtochoosesurgery,thetimingofsurgeryiscloselyrelatedtothesofttissueinjury.Forfracturereduction,theearliersurgeryisrelativelyeasy,butitalsoincreasestheincidenceofpostoperativecomplications.Theidealsurg